Quote:
Originally Posted by warhorse78
I remember reading that hospitals were formed because a religious community would gather and have fund raisers so they can raise the money to send their brightest and best people of the communities to college to become doctors and study medicine, then they would come back to the communities and build hospitals so the sick can go there and heal. It's why so many hospitals today are named after some religious saint, and will have the Jesus Christ cross as the official emblem of healing centers.
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That is not why.
Hospitals never healed a damn thing.
It is true that nearly every single Catholic religious order founded large numbers of hospitals, as did the synods for the Methodist, Baptist, Anabaptist, Presbyterian and Lutheran sects, and Jewish groups.
A typical hospital would like St Francis Hospital for the Incurables.
Hospitals were hospices -- you went there to die, not get healed.
If you needed surgery or a limb amputated, your doctor did that in his office, not the hospital.
It was only after the Civil War that surgeries started to be occasionally performed in hospitals.
Most surgeries were actually successful. It was the post-surgical complications from infection that resulted in death, because no antibiotics existed, and the surgical environment was hardly sterile.
It was the X-ray machine that made the big change.
People started going to hospitals for X-rays for broken bones, instead of having the doctor come to them, and yes, doctors usually always came to your home, and they did up until the 1950s, but doctors in rural areas continued to make house calls into the 1960s.
It wasn't until the 1920s that hospitals became half hospice and half healing, and then a few decades later they pretty much abandoned the hospice function.
Quote:
Originally Posted by warhorse78
When did our medical industry go from wanting to heal to wanting to bankrupt the world with outrageous costs of medical care?
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When your federal and State governments and the American Hospital Association screwed the pooch.
Your healthcare system is screwed up solely because your governments made 5 major egregious errors.
In the 1920s there arose a long standing feud between doctors and hospitals.
Doctors aligned with the American Medical Association (AMA) and wanted total and complete control.
If a doctor thought that the best interests of the patient were served by performing a particular surgery at Good Samaritan Hospital, then that is where doctor and patient should be.
But, if the doctor thought the patient's best interests were served by performing the surgery at St Francis, or St George, or Mercy or Bethesda or Christ or Jewish or Deaconess or Provident Hospitals, then doctor and patient should be free to go to anyone of those hospitals for the surgery.
Doctors also charged a sliding-scale fee. If you were poor, maybe you'd pay $0.50 for a house-call, but if you were a little better off, maybe $0.70 and if you were rich, maybe a whole $1 (and that's what some doctors actually charged).
The American Hospital Association (AHA) had a different view.
The AHA demanded total control over doctors and that they own doctors. A doctor performs surgeries at this hospital only,
and no other, if and when the hospital decrees the surgery should be performed.
The AHA charged a flat fee for all patients regardless of income and demanded doctors do the same.
In the 1920s, hospitals started aligning with the AMA or AHA. 80% of hospitals were AHA-members, and 20% were AMA-members.
In 1929, the hospital at Baylor University issued the first ever pre-paid hospitalization plan, and it was for teachers in Dallas County, Texas. It cost $6 for $22,000 of hospital healthcare.
Within months, nearly every hospital was offering pre-paid hospitalization plans. Note that insurance companies did not offer healthcare plans.
Around 1932, the AHA started grouping member-hospitals together in metropolitan areas across the US. The plans were standardized with the same fee, instead of each hospital issuing its own plan at different fees. AMA hospitals followed suit.
The States recognized those plans for what they were, which is insurance, and of course States were looking to increase their revenues during the Great Depression, so they wanted the hospitals to come under State insurance regulations and maintain the cash and assets reserves required for insurance.
The AHA lobbied the States for "enabling laws" that exempted the hospitals from insurance regulation, and also allowed them to operate as monopolies and cartels, under the guise they would provide free healthcare for low-income patients.
The AHA now created the "Out-of-Network" policy.
The AHA would only accept plans from AHA-member hospitals, and not AMA-member hospitals in order to drive the AMA-member hospitals out of business.
That was the 1st major mistake.
The 2nd major mistake comes when FDR levies Wage & Price Controls to combat Wage Inflation. Price controls are acceptable, but wage controls are not. To give you a pay raise, your employer must now receive prior written authorization from the National Labor Board.
To get around that, employers started offering to pay for pre-paid hospitalization plans.
You chose the plan, not your employer: your employer simply paid all or part of it as compensation in lieu of wages.
The 3rd major error comes when the now-turned National War Labor Board declares pre-paid hospitalization plans as fringe benefits in 1942, much to the chagrin of the IRS.
In 1946, the AHA created the Blue Cross, and collectively converted all plans from AHA-member hospitals into Blue Cross plans.
The AHA's "Out-of-Network" policy remained in effect.
The AMA followed suit a few months later with the creation of the Blue Shield.
The long-running feud between the AHA and AMA is now more intense than ever.
The 4th major error is the 1949 US Supreme Court
In Re: Inland Steel decision.
You're no longer allowed to choose your own plan, because your employer now does that for you, whether you like it or not.
Thank you federal government for screwing Americans.
The 5th major error your governments made is the 1954 IRS Tax Code.
Some insurance companies jumped into the healthcare field in 1946 with the creation of the Blue Cross, but after 1949 they were all in it.
The insurance companies provided life-insurance coupled with catastrophic health insurance, the only type of insurance available at the time.
It worked like this: you pay premiums for 10 years,
and 10 years only, and then
you never pay another dime for the rest of your life, but you and your spouse (and minor children) are covered until the day you die.
When you die, your named beneficiaries get $100,000 (which today is about $1 Million).
If you used $25,000 worth of health insurance, then your named beneficiaries would get $75,000 (worth about $750,000 today).
What a fantastic way for low-income and middle-income families to build wealth and pass that wealth on to their children or grandchildren.
Problem: the AHA's Blue Cross is not a true insurance company, and cannot offer life-insurance coupled with catastrophic health coverage.
The AHA's Blue Cross market share dropped from 80% to 54% in just two years, with the hemorrhaging continuing.
The AHA lobbied Congress to change the tax laws to prevent low-income and middle-income families from generating wealth and passing it on.
Thank you federal government and AHA for screwing Americans.
That's why your healthcare system is screwed up.
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